Individual
DR. MICHAEL VANN LEGRAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8324 CROSSLAND LOOP, MONTGOMERY, AL 36117-8482
(334) 279-1166
Mailing address
3442 BANKHEAD AVE, MONTGOMERY, AL 36111-1334
(334) 288-6457
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4643
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51501170
BCBS OF AL
AL
01
—
801709
UNITED CONCORDIA
AL
Enumeration date
07/27/2006
Last updated
07/08/2007
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